Recent UK press reports have highlighted an alleged error in hip implant manufacturing. According to a story that broke in The Telegraph, metal-on-metal implants with manufacturing issues mean thousands could be seeking compensation from DePuy.

Of course, we’re not talking medical plastics here but it’s not the only press focus the sector has had of late. An increasing number of women are requiring hip replacements in their 40s. In the UK one-time ballerina, now a judge on a prime-time TV dancing show, Darcey Bussell announced that she had her hip resurfaced but may need a hip replacement due to the toll dancing has taken on her body.

Keep on running?

Professional dancers aren’t the only ones experiencing the need for this type of orthopaedic surgery. According to the Daily Mail, “In 2013, 66,000 replacements were carried out - and the number is increasing. But while most are given to people aged 60 to 80, operations on younger patients are becoming more common, according to leading orthopaedic surgeon, Mr Tim Waters of Spire Bushey Hospital”. And the reason? Exercise. With younger people requiring these type of joint replacements – made from a combination of stainless steel, titanium, plastic and ceramic – the orthopaedic market is encountering additional growth. The sector already benefits from a rising elderly population as well as an increase in obesity, osteoarthritis and osteoporosis. According to a report by Transparency Market Research technological advances such as bio-absorbable implants and the increase in the success rate of these implants, make this sector an attractive opportunity for investors. The orthopaedic market is a significant part of the medtech sector – figures from EvaluateMedTech place it third behind cardiology and in vitro diagnostics.

Evonik investment

Developments in the sector are on-going. Evonik Industries recently invested in start-up company Synoste via its venture capital arm and now holds a minority share in the medical technology company.

Synoste is a spin-off of the Aalto University in Finland. Together with Orton, a Helsinki hospital which specialises in orthopaedics, Synoste has developed a high-tech implant for a minimally invasive treatment of leg length discrepancy, which can lead to chronic back pain and osteoarthritis in the long term. The bone of the shorter leg is lengthened gently over the period of several months. For the patient the implant represents easier treatment with less pain and lower risk compared with established methods.

"Medical technology is one of the strategic growth fields of Evonik," says Bernhard Mohr, head of venture capital at Evonik. "At the same time, we have outstanding materials competence in high performance polymers, which makes Synoste an excellent fit for Evonik."

The start-up is expected to launch the implant – NitinailTM – on the market in 2017. It is currently undergoing CE approval.

"We are happy to have found a strategic partner in Evonik, who is supporting us in this important phase with its material competence," explains Harri Hallila, CEO and co-founder of Synoste.

VESTAKEEP PEEK, a high performance polymer from Evonik, will also be used in the implant. Due to its mechanical properties and biocompatibility, VESTAKEEP PEEK is well established in implant, dental and medical technologies.

"By investing in Synoste we hope to open up a new, extremely innovative application for VESTAKEEP PEEK and enhance our business and expertise in the field of medical technology," says Matthias Kottenhahn, who heads the high performance polymers business line at Evonik. Synoste’s implant technology does not just offer potential in leg-lengthening but also for deformities in arms, fingers and toes as well as spine and craniomaxillofacial surgery.

Better quality of life for patients

There are various reasons why legs might be different in length ­­– this could occur from birth or as a result of an accident or cancer. According to estimates, some 30,000 people worldwide receive treatment per year. The standard treatment method involves the use of an external fixator – a construction made of steel which is fixed to the bone and the outside of the leg. This method does, however, pose the risk of infection and is also painful and uncomfortable.

The implant offered by Synoste is similar to an intramedullary nail and is fixed to the bone after the bone has been cut. During the treatment period, which lasts for several months, it is extended in small increments of 0.5 millimeters, like a telescope, by electromagnetic means. This causes fresh bone substance to steadily form between the two halves of the bone. Using this method, it is possible to increase the length of the bone by several centimetres.

An advantage of the implant from Synoste is said to be its high mechanical stability. Synoste targets to allow patients to bear full weight on their leg at an early stage in the treatment process. Furthermore, it significantly reduces the risk of infection compared to a fixator and requires shorter hospitalisation.